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[Acute psychoses caused by digitalis poisoning]
Z Duraković1, B Vucelić, F Plavsić
1Klinika za unutarnje bolesti s poliklinikom Rebro, Medicinski fakultet Sveucilista u Zagrebu.
Lijecnicki Vjesnik
|November 1, 1991
Summary
A 76-year-old woman experienced acute psychosis after increasing her medigoxin dosage. Symptoms resolved after discontinuing medigoxin, highlighting potential digoxin toxicity in elderly patients.
Area of Science:
- Cardiology
- Psychiatry
- Clinical Pharmacology
Background:
- This case report details a 76-year-old female patient with a history of dyspnea.
- The patient was initially treated with medigoxin 0.1 mg daily.
Observation:
- The patient's medigoxin dosage was increased to 0.2 mg daily.
- Within five days of the increased dosage, she developed acute psychosis and cardiac abnormalities, including 50% monomorphous ventricular premature beats and S-T segment depression.
Findings:
- Serum digoxin concentration was elevated (4.0 nmol/L two days after discontinuation, and 2.2 nmol/L five days after), suggesting digoxin toxicity precipitated the psychosis.
- Cardiac arrhythmias and psychotic symptoms resolved after medigoxin discontinuation and a single dose of promazine.
Implications:
- This case underscores the importance of monitoring digoxin levels in elderly patients, especially when dosages are increased.
- It highlights the potential for digoxin toxicity to manifest as acute psychosis and cardiac arrhythmias.
- Careful dose titration and therapeutic drug monitoring are crucial for safe digoxin use in geriatric populations.